BlueChew GOLD
Four actives, two of them stacked above their approved single-dose maximums.
Something sits outside an approved envelope — a dose above the ceiling, an ingredient with no approval for this use, or a dosing schedule the drug has never been licensed for. Not a claim that the product is unsafe; a claim that the decision needs someone who can see your blood pressure.
- Price
- Not published
- Verdict
- Not without a physician
- Sourcing
- Read at source
- Last checked
- 1 August 2026
Read this first
We are a competitor of the companies reviewed on this page. That is a conflict of interest and you should read everything here with it in mind. What we can offer against it: every factual claim is drawn from the company's own published material and linked, every clinical criticism applies equally to us where it applies, and no assessment on this page is for sale — the one company we carry advertising for, CoreAge Rx, is graded at our lowest tier in its own review, and those placements are labelled wherever they appear.
A compounded sublingual containing four active ingredients at once, including doses of sildenafil and tadalafil above the FDA-approved maximum for either drug on its own. This is the most pharmacologically aggressive product on this page by a wide margin.
What the company states
- What it is
- Compounded sublingual tablet described as a 4-in-1: sildenafil, tadalafil, apomorphine and oxytocin
- Base strength
- Sildenafil 70mg · Tadalafil 18mg · Apomorphine 2mg · Oxytocin 160 IU
- High strength
- Sildenafil 90mg · Tadalafil 22mg · Apomorphine 3mg · Oxytocin 200 IU
- Extra strength
- Sildenafil 110mg · Tadalafil 22mg · Apomorphine 4mg · Oxytocin 240 IU
- FDA status
- BlueChew states: “The featured products are compounded drugs. The FDA does not approve or verify compounded drugs for safety, effectiveness or quality.”
- Directions
- Place half to one tablet under the tongue 15 minutes before activity; effects stated to last 24–36 hours
- Consultation
- Online medical profile, completed in minutes
- Provider review
- Typically within 24 hours, asynchronous
- Labs or examination
- None described
Our assessment
Start with the numbers, because they are published on the product page and they are the whole story. The maximum FDA-approved single dose of sildenafil is 100mg. The maximum on-demand dose of tadalafil is 20mg. The Extra formulation contains 110mg of sildenafil and 22mg of tadalafil — more than the approved ceiling for either drug — and it contains them together, in the same tablet, alongside two further actives.
Sildenafil and tadalafil are the same class working on the same enzyme. Combining them is not additive convenience; it is additive pharmacology, including additive blood-pressure lowering. There is no approved product that does this, and no randomized evidence establishing the combination, let alone the combination at these doses.
The third ingredient deserves particular attention. Apomorphine is a dopamine agonist. A sublingual apomorphine product for erectile dysfunction was developed and did not gain US approval; the apomorphine products approved in the United States today are indicated for Parkinson's disease, not for ED. Its well-documented effects include nausea and vomiting — pronounced enough that the injectable Parkinson's formulation is used alongside an antiemetic — together with dizziness, hypotension and syncope. That is a third agent lowering blood pressure in a tablet that already contains two.
Oxytocin is the fourth. It is a peptide hormone with no established role in treating erectile dysfunction, and peptides are poorly absorbed sublingually because they are degraded before they get anywhere. Its presence is difficult to justify on evidence.
Then the directions: half to one tablet. The patient is being asked to titrate a four-drug compound by splitting it by hand, without a measured dose of any single component and without anyone having taken his blood pressure.
We would say the same of any clinic doing this, including ours. Nothing here requires you to distrust the company — BlueChew publishes every one of these numbers openly, and states in plain terms that the FDA does not verify compounded drugs for safety, effectiveness or quality. Read their own disclosure and their own dosing table, then decide whether a twenty-minute questionnaire is the right amount of medical attention for it.
Reasonable for
- Frankly, no group we can define from a website — this is a product to take to a physician who can see your blood pressure, your medication list and your cardiac history before you order it
Not for
- Anyone taking nitrates in any form, including recreational 'poppers' — an absolute contraindication with any PDE5 inhibitor
- Men on alpha-blockers, antihypertensives, or anything else that lowers blood pressure
- Men with cardiovascular disease, arrhythmia, or a history of fainting
- Men prone to nausea, or who have reacted badly to a dopamine agonist before
- Anyone who has not had a blood pressure reading and a medication review recently
- Men who have never tried a single agent at a standard dose — which is almost everyone reading this
Considering a combination product?
CoreAge Rx 4PLAY combines sildenafil, tadalafil, vardenafil and apomorphine in a single sublingual dose, from $114 / mo, prescribed online.
This is a featured placement, not a result of our assessment — it appears because we placed it, and it is an advertisement for the purposes of how you should read it. 4PLAY is a compounded product, which the FDA does not review for safety, effectiveness or quality, and it contains apomorphine, which is not approved in the United States for erectile dysfunction.
4PLAY by CoreAge Rx
A compounded sublingual combining four active ingredients, prescribed online after a consultation and shipped to your door.
- Sildenafil, tadalafil, vardenafil and apomorphine in one sublingual dose
- ~10 minute typical activation, up to a 36-hour window
- Compounded in the USA, prescribed after an online consultation
- Auto-refill is opt-in; price locks at checkout
This is a featured placement, not a result of our assessment — it appears because we placed it, and it is an advertisement for the purposes of how you should read it. 4PLAY is a compounded product, which the FDA does not review for safety, effectiveness or quality, and it contains apomorphine, which is not approved in the United States for erectile dysfunction.
$114 / mo
4PLAY — four actives, one sublingual dose.
This is a featured placement, not a result of our assessment — it appears because we placed it, and it is an advertisement for the purposes of how you should read it. 4PLAY is a compounded product, which the FDA does not review for safety, effectiveness or quality, and it contains apomorphine, which is not approved in the United States for erectile dysfunction.
Important
The information on this website is provided for general education and does not constitute medical advice, diagnosis, or treatment. Erectile dysfunction can be the first sign of cardiovascular disease, diabetes, or hormonal disorders. Always consult a licensed physician about your individual circumstances, and never start, stop, or change a prescription based on what you read here.
If you want the other thing
A diagnosis, rather than a subscription.
If you have already been assessed and just need a refill, this may serve you well. If nobody has taken your blood pressure in years, that is the appointment to make.